A new rating scale of functional impairment and activity specific for muscular dystrophy: from integration to validation
| Autor: | Yi-Jing Lue, 呂怡靜 |
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| Rok vydání: | 2006 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 94 The purposes of this research were to develop a reliable and valid new rating scale for measuring functional impact of muscular dystrophy (MD). This research included two parts of studies and combined prospective and longitudinal investigations. The first part of studies was to explore patterns of functional deficits associated with different types of MD. The second part of studies was to develop Muscular Dystrophy Functional Rating Scale (MDFRS). The results of first part would greatly contribute to the later development of the MDFRS. Scale development consisted of three stages. In stage I, a preliminary pool of 53 items was generated from patient interviews (n = 25), literature review, existing functional rating scales, and expert opinion. In stage II, these items were administered to 85 patients with MD. The resulting data were analyzed to construct the MDFRS that encompassed four unidimensional constructs: mobility, basic activities of daily living, arm function, and impairment. In stage III, the measurement properties of this rating scale were assessed in 121 MD patients different from those examined with the preliminary instrument. Statistical techniques such as Cronbach’s alpha, Spearman’s correlation, Intraclass correlation coefficients, coupled with exploratory and confirmatory factor analyses were performed to delineate the psychometric properties of the MDFRS. Internal consistency reliability was excellent for all domains of the final 33-item scale, with values of Cronbach’s alpha ranging from 0.84 to 0.97. Intraclass correlation coefficients for test-retest and inter-rater reliability were 0.99 for all domains of the MDFRS. The MDFRS showed moderate to high correlations with a range of functional rating scales measuring similar aspects and impairment parameters (Spearman’s rho = 0.65-0.91; p < .001, each). Confirmatory factor analysis supported a unitary construct of the four-dimensional MDFRS. The MDFRS had small floor and ceiling effects in the study samples. Sensitivity to change was confirmed by large standardized response means for the MDFRS total score. In conclusion, the MDFRS is a reliable and valid disease specific measure of functional status for patients with MD. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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